Comparative effects of erythropoietin with oral iron in peritoneal dialysis and hemodialysis patients.

The studies on the comparative efficacy of erythropoietin (rHuEPO) in chronic hemodialysis and peritoneal dialysis patients are scarce. We compared the use of rHuEPO in 74 stable patients on hemodialysis to 24 on chronic peritoneal dialysis. All patients were on oral iron supplement. In peritoneal dialysis patients hematocrit was 23.1% and 30.1%, rHuEPO dose 80.9 U/kg/week, while in hemodialysis patients hematocrit was 21.2% and 27.5%, and rHuEPO dose was 140.2 and 165.0 U/kg/week at commencement and after 6 months, respectively. Serum iron and transferrin saturation were unchanged in peritoneal dialysis patients, but decreased in hemodialysis patients with rHuEPO therapy. These findings suggest that rHuEPO is more effective in peritoneal dialysis patients than in hemodialysis patients receiving oral iron. The improved efficacy of rHuEPO in peritoneal dialysis may be due to decreased blood loss, subcutaneous administration, and/or better removal of inhibitors of erythropoiesis. Peritoneal dialysis may be more cost-effective and desirable than hemodialysis for rHuEPO-dependent or -resistant patients.